5 years ago

Improved treatment and control of hypertension in Swedish primary care: results from the Swedish primary care cardiovascular database

Wettermark, Björn, Manhem, Karin, Holmquist, Charlotte, Bengtsson Boström, Kristina, Hasselström, Jan, Kahan, Thomas, Hjerpe, Per
imageObjective: To study temporal trends in hypertension treatment and control in Swedish primary care, in relation to clinical characteristics, comorbidity, and drug treatment. Materials and methods: Repeated cross-sectional analysis of 43 239 hypertensive patients attending primary care in 2001–2002 and of 62 407 patients in 2007–2008. Results: Mean blood pressure (BP) 2007–2008 was 143/79 mmHg in women and 142/81 mmHg in men. Cardiovascular comorbidity and diabetes were present in 13 and 15% of women, and in 18 and 20% of men. Overall BP reductions from 2001–2002 to 2007–2008 were 9.0/3.1 mmHg; greater in women than men, with advancing age, and in patients with comorbidity (all P < 0.001). Attainment of target BP (<140/90 mmHg) increased from 24 and 26% in women and men (2001–2002) to 37 and 37% (2007–2008; all P < 0.001). Most common drug classes in 2001–2002 were, in descending frequency, β blockers, diuretics, and calcium channel blockers (both sexes), and in 2007–2008 β blockers, diuretics, and angiotensin-converting enzyme inhibitors in women, and β blockers, angiotensin-converting enzyme inhibitors, and diuretics in men. The number of drug classes/patient increased from 1.5 (2001–2002) to 1.8 (2007–2008; P < 0.001) but remained low (1.7) in those above target BP. Conclusion: BP control in hypertensive patients attending Swedish primary care has improved over 5–7 years, and more so in high-risk groups. There is, however, room for improvement. In uncontrolled hypertension the combination of several drug classes remain low.
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